| Crown Vision Center | |
|
111 E 4th St Ste 440, Alton, IL 62002-6206 | |
| (618) 462-9818 | |
| (314) 741-4947 |
| Full Name | Crown Vision Center |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 111 E 4th St Ste 440, Alton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295737294 | NPI | - | NPPES |
| DC7072 | Other | MO | RAILROAD MEDICARE |
| CK2084 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Chih Jen Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861443079 PECOS PAC ID: 3375433717 Enrollment ID: I20040617000538 |
| Provider Name | Mark D Wade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376512137 PECOS PAC ID: 8527043868 Enrollment ID: I20040622000116 |
| Provider Name | Christina J Levi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417924648 PECOS PAC ID: 2961536602 Enrollment ID: I20101007001075 |
| Provider Name | Jacqlyn E Long |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992866057 PECOS PAC ID: 2365546421 Enrollment ID: I20140410000325 |
| Provider Name | Natalie J Carr |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235519190 PECOS PAC ID: 9830402478 Enrollment ID: I20150724011665 |
| Provider Name | Jacqueline Fiddler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013532480 PECOS PAC ID: 6103241757 Enrollment ID: I20200730001068 |
| Provider Name | Robert Fullenwider |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699386755 PECOS PAC ID: 0648698159 Enrollment ID: I20201014000165 |
| Provider Name | Theresa Marie Oliver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427588185 PECOS PAC ID: 5092125567 Enrollment ID: I20201208000576 |
| Provider Name | Katlyn Rene Peterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538768007 PECOS PAC ID: 5193138329 Enrollment ID: I20210108000066 |
| Mailing Address | Practice Location Address |
|---|---|
| Crown Vision Center 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 | Crown Vision Center 111 E 4th St Ste 440, Alton, IL 62002-6206 Ph: (618) 462-9818 |
Aeg Delaware Professional Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 | |
Aeg Connecticut Professional Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 Fax: 314-741-4947 | |
Dr. James Walter Lieber, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 401 Henry St, Alton, IL 62002 Phone: 618-465-6000 | |
Mark D. Wade O D P C Optometrist Medicare: Not Enrolled in Medicare Practice Location: 111 E 4th St Ste 440, Alton, IL 62002 Phone: 618-462-9818 Fax: 314-741-4947 | |
Clarkson Eyecare Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1819 Homer Adams Parkway, Suite B, Alton, IL 62002 Phone: 636-200-4393 Fax: 636-938-2650 | |
Pearle Vision Of Alton, P.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2865 Homer M Adams Pkwy, Alton, IL 62002 Phone: 618-465-1654 Fax: 618-465-8652 |